The Effect of Perineural Invasion on Overall Survival in Patients with Gastric Carcinoma

Aims  The availability of different treatment options for gastric carcinoma has reopened the question of correct definition of high-risk categories, which may help in identifying patients with high risk for poor prognosis who would benefit more from adjuvant therapy after operation. Perineural invasion (PNI) seems to provide useful information for management. Therefore, we examined the effect of PNI on overall survival (OS) in patients with gastric carcinoma and the association between PNI and other clinical and pathological factors. Patients and Methods  A total of 1,632 patients with gastric carcinoma from 2000 to 2005 were analyzed retrospectively. Paraffin sections of surgical specimens from all patients who underwent gastric resection were stained with laminin. If carcinoma cells infiltrated into the perineurium or neural fascicles, PNI was assessed as positive. Survival analysis was done in 1,372 patients with T1–T4 tumors who underwent curative resection. Result  PNI was positive in 518 of the 1,632 patients (31.7%). The size of tumors, T stage, differentiation of tumor, and clinical stage were significantly related to PNI positivity. The proportion of large tumors was significantly higher in PNI-positive patients than in PNI-negative patients (P < 0.01). As the depth of gastric mural invasion or clinical stage increased, the positive rate of PNI also increased. The OS of the PNI-positive patients was significantly shorter than that of the PNI-negative patients in the univariate analysis (P < 0.01). At multivariate Cox proportional hazards model of OS analysis, the positivity of PNI appeared to be an independent prognostic factor for OS (hazards ratio [HR] = 3.23, 95%CI = 2.6–8.11, P < 0.01), which was also influenced by tumor differentiation, T stage, and clinical stage (P < 0.01). Conclusion  Our results suggested that the incidence of PNI was high in gastric carcinoma and that it corresponded to the progression of disease. It could provide additional information for identifying patients who are at high risk for poor prognosis. PNI can be a candidate for a new kind of prognostic parameters.     

促进断指再植功能恢复的治疗和康复措施

本文总结了再植成功31个手指功能恢复的治疗。指出术中小血管的精细吻合，扩血管药和抗凝药的正确使用是再植成功的关键。早期的康复治疗以消除肿胀、粘连，恢复皮肤和肌腱的弹性为主；中期以促进骨折愈合，末梢神经再生和活动未固定和关节为主，后期以主动功能锻炼和恢复手指功能为主。     

纤维连接蛋白在中耳粘连形成中的作用

为了解纤维连接蛋白(fibronectin ,Fn)在中耳粘连形成中的作用 ,采用新的火棉胶切片抗原恢复技术及超敏感的生物素 链霉卵白素法 (supersensitivebiotin streptavidin ,SSBSA)检测了粘连中耳在不同期Fn的含量。对结果采用光学显微镜下定性分析 :在中耳粘连各期Fn含量以阳性和强阳性为主 ,而正常组以阴性和弱阳性为主 ;计算机辅助定量分析 :正常组、纤维粘连期、细胞反应期、肉芽期、渗出期Fn含量吸光度 (A)值分别为(17 43±2 91)、(4 4 2 7± 4 5 0 )、(32 2 7± 8 33)、(2 8 91± 7 6 4)、(35 17± 14 2 8) ,正常组与粘连各期间有差异 (P <0 0 5 ) ,粘连各期间差异不明显 (P >0 0 5 )。提示Fn参与了中耳粘连的形成 ,其主要作用机制可能是促进粘连的始动物质———凝胶基质的形成。     

高温下身着防毒服作业时肛温与皮温的关系

目的：探索高温下身着防毒服活动时肛温与皮温的变化关系，为个体中暑预警装置提供相应实验数据。方法：19名男性健康青年，着全身式防毒服在干球温度为35．0－37．0℃、湿球温度为30．0－33．0℃的人工热气候室内进行踏阶、跑步等活动，用日本光电600型八道生理记录仪连续观察其肛温与皮温的变化，当肛温达39．4℃以上或自觉不能继续坚持实验时终止。结果：受试者肛温（Y）与右腰皮温（X1）、右胸皮温（X2）和右背皮温（X3）之间存在着良好的相关，肛温与上述三点皮温的相关系数分别为0．988、0．982和0．975；肛温与三点皮温的直线回归方程分别是：Y1＝9．489＋1．279X1，Y2＝1．990＋0．973X2，Y3＝4．036＋0．909X3。结论：三点皮温可代替肛温作为个体中暑预防装置的监测指标。     

Etiologic and serologic investigations of the 1980 epidemic of dengue fever on Hainan Island, China

Virologic and seroepidemiologic studies were carried out during an epidemic of dengue fever on Hainan Island in 1980. Dengue 3 virus was isolated from 46 of 77 acute phase sera and from 1 of 10 pools of adult Aedes aegypti. Dengue 1 virus virus was isolated from a single acute phase serum. Seroepidemiologic investigations showed that 74% of healthy individuals in the epidemic area had antibody to dengue virus compared to 54% in an area where epidemic dengue had occurred in 1978, and less than or equal to 8% in nonepidemic areas. There were no significant differences in antibody prevalence for different sex and age groups.     

重症急性胰腺炎的治疗探讨

目的：探讨重症急性胰腺炎（SAP）的治疗方法。方法：回顾性总结1995－2000年重症急性胰腺炎83例的治疗资料。结果：其中保守治疗37例，手术治疗46例，治愈69例，死亡14例，总病死率为16．9％，重症I组级52例，死亡4例；重症Ⅱ级31例，死亡10例，重症I级，Ⅱ级患者病死率分别为7．7％，32．3％，二组间差异有显著性意义（P＜0．05），结论：SAP病死率与胰腺炎的严重性有显著相关性，应根据病情而选择治疗方案，手术时机是重要影响因素，围手术期处理相当重要。     

降脂减肥茶长期毒性实验研究

目的:观察降脂减肥茶的长期毒性。方法:降脂减肥茶高、中、低剂量组按7g/kg、3.2g/kg、1.5g/kg给SD大鼠灌胃,分别相当于临床用量的100倍、50倍、20倍。给药6周、12周和停药3周后,观察大鼠的行为活动、食欲、二便、体重、血液学和血液生化学指标,以及主要脏器系数和病理组织学检查。结果:3个给药组分别与对照组比较,各项指标差异无显著性意义。结论:本品在临床推荐的用药剂量下有一定的安全性。     

卡维地洛治疗充血性心力衰竭的疗效观察

目的观察卡维地洛对充血性心力衰竭（CHF）的临床疗效。方法将48例CHF患者随机分为治疗组和对照组,对照组24例,给予常规抗心力衰竭治疗（地高辛、利尿剂、ACEI）;治疗组24例,在对照组常规治疗基础上加用卡维地洛,卡维地洛从初始剂量2.5㎎,每日两次开始,根据耐受情况逐渐上调至最大耐受量40㎎/天,疗程3个月。观察治疗前后患者血压、心率、左室收缩末期内径（LVESD）、左室舒张末期内径（LVEDD）、左室射血分数（LVEF）的变化。结果治疗组总有效率（91.7%）明显高于对照组（75%）,差异有显著性（P〈0.05）。两组血压、心率、LVESD、LVEDD及LVEF均较治疗前明显改善（P〈0.05或P〈0.01）,但治疗组较对照组改善更为明显（P〈0.05或P〈0.01）。结论卡维地洛对充血性心力衰竭的治疗有显著效果。     

克拉维酸/阿莫西林分散片与普通片的人体相对生物利用度研究

目的　利用反相液相色谱法比较克拉维酸 /阿莫西林分散片与克拉维酸 /阿莫西林普通片安奇的人体生物利用度。方法　 18名男性健康志愿受试者采用两周期随机交叉试验 ,分别口服克拉维酸 /阿莫西林分散片与克拉维酸 /阿莫西林普通片安奇 (克拉维酸 12 5mg ,阿莫西林 5 0 0mg)。用HPLC法同时测定血浆中克拉维酸和阿莫西林的浓度 ,计算克拉维酸和阿莫西林的药代动力学参数 ,计算分散片的相对生物利用度。结果　分散片和普通片克拉维酸的Tmax为(0 89± 0 2 5 )h和 (1 0 1± 0 30 )h ;Cmax为 (1 92± 0 6 4 )mg·L-1和 (1 4 9± 0 6 5 )mg·L-1;AUC0→∞ 为 (4 347±1 5 4 2 )mg·h·L-1和 (3 395± 1 4 6 8)mg·h·L-1,相对生物利用度 15 1 0 9%± 86 0 0 %。阿莫西林Tmax 为 (1 15±0 4 1)h和 (1 34± 0 4 0 )h ;Cmax(5 81± 1 4 0 )mg·L-1和(4 6 0± 1 37)mg·L-1;AUC0→∞ 为 (13 4 72± 3 114 )mg·h·L-1和 (11 937± 2 735 )mg·h·L-1,相对生物利用度118 4 1%± 31 5 6 %。两者间除阿莫西林Tmax的差异无统计学意义外 ,克拉维酸 /阿莫西林分散片的克拉维酸Tmax小于克拉维酸 /阿莫西林普通片安奇的克拉维酸Tmax(P <0 0 5 ) ,克拉维酸 /阿莫西林分散片的克拉维酸Cmax、AUC0→∞ 和阿莫西林Cm     

合欢皂苷J20的结构鉴定

目的:研究合欢皮的化学成分及活性。方法:用现代色谱法分离合欢皮皂苷,用化学和现代波谱法,主要是二维核磁共振技术鉴定结构。结果及结论:分离并鉴定了一个新三萜皂苷,结构为3-O-[β-D-吡喃木糖基-(1→2)-α-L-吡喃阿拉伯糖基-(1→6)-β-D-吡喃葡糖基]-21-O-｛(6S)-2-反式-2-羟甲基-6-甲基-6-O-β-D-吡喃木糖基-2,7-辛二烯酰基｝金合欢酸28-O-β-D-吡喃葡糖基-(1→3)-[α-L-呋喃阿拉伯糖基-(1→4)]-α-L-吡喃鼠李糖基-(1→2)-β-D-吡喃葡糖基酯,命名为合欢皂苷J₂₀(JulibrosideJ₂₀)。